Breastfeeding Beyond Infancy
There is this strange idea floating around society that says babies should stop breastfeeding after 1 year. I even had an original goal to breastfeed my own child for 12 months just because I knew that’s how long babies needed formula for, so I had wrongfully assumed breast milk would be useless after my baby’s first year as well. Luckily, I learned how much breastfeeding continues to benefit mother and child past infancy. Furthermore, many health organizations recommend breastfeeding for at least 2 years or beyond because of the many continued health advantages.
According to the American Academy of Family Physicians, that children weaned before two years of age are at increased risk of illness (AAFP 2008).¹
So let’s talk about those health benefits. Because a child’s gut health is established by 2.5 years and cannot be easily changed thereafter, it makes perfect sense that health organizations recommend breastfeeding for at least 2 years⁴. Breast milk coats the intestines in the baby’s first days of life which will help lead to reduced risks of allergies and promote good gut health which contributes to a strong immune system. Since it can take between 2 and 6 six for our immune systems to fully develop, breastfeeding can continue to provide added protection our children need until then².
As far as nutrition, human milk is the perfect food for our children as it lacks nothing and provides all the nutrients our babies need during their first year. Only in special circumstances will an exclusively breastfed baby need supplements or vitamins in addition to breast milk; most healthy, full term babies get their complete nutrition from mother’s milk and the nutritional components are present for as long as a child nurses.¹’²
Maybe you’ve heard the following comments while breastfeeding your older child, “OMG, doesn’t he have teeth?!”, “can’t he drink from a cup instead?”, or, my personal favorite, “how long are you going to breastfeed for?”. Because breastfeeding is not normalized in our culture, many people are confused and misinformed about breastfeeding. Despite such irrational claims, there is no medical basis or scientific evidence to prove breastfeeding beyond infancy is harmful to mother or child. In fact, medical professionals state that there is “damage caused by modern practices of premature weaning”.¹
Unfortunately, many people truly believe breastfeeding is “ineffective” after infancy. I’ve heard that my child doesn’t “need” breast milk after 1 year and that it stops providing nutritional benefits. This is wrong for some many reasons because: 1) my child DOES continue to “need” to be breastfed for comfort and 2) breastfeeding not only contributes to our children’s health after the first year, but it fulfills over one quarter of a child’s daily energy requirements in addition to providing essential vitamins and nutrients. In fact,“Breastfeeding toddlers between the ages of one and three have been found to have fewer illnesses, illnesses of shorter duration, and lower mortality rates (Mølbak 1994, van den Bogaard 1991, Gulick 1986).”¹.
“In the second year (12-23 months), 448 mL of breastmilk provides:
29% of energy requirements
43% of protein requirements
36% of calcium requirements
75% of vitamin A requirements
76% of folate requirements
94% of vitamin B12 requirements
60% of vitamin C requirements
— Dewey 2001” ¹
Another misconception is that children need to switch to cow's milk at a certain point. This is simply what our society has been conditioned to believe thanks to great marketing strategies. Although indulging in delicious dairy treats may not be harmful for some of us, there is no true health or medical reason for our children to drink anything besides human milk and water (after 6 months). Each mammal has their own milk specifically made for their offspring and in no other circumstances do any other species drink each other’s milk as it is simply not necessary⁵. Once our children begin eating solids, we can guide them to eat a well-balanced diet which will help them meet all of their nutritional needs as they grow.
The global organization of physicians has stated that “Human milk contains nutrients, antibodies, and immune-modulating substances that are not present in infant formula or cow’s milk.”¹
Our children receive more than just physical health benefits from human milk. The act of breastfeeding also continues to contribute to our children’s emotional health, intellectual development, as well as their social development. Breastfeeding allows us to easily continue to connect with our children on a daily basis and will enable them to become independent at their own pace when they are ready by creating a healthy and secure attachment. Furthermore, there are greater gains in these areas for children who are breastfed the longest².
“Extensive research on the relationship between cognitive achievement (IQ scores, grades in school) and breastfeeding has shown the greatest gains for those children breastfed the longest."¹
To be completely honest, I don't know what I'd do if I didn’t breastfeed my son. Breastfeeding continues to allow me to soothe and comfort my child as he overcomes the daily struggles in the life of a toddler. He is learning so much so fast and is growing and changing every day. We are both grateful to have one constant and certain thing in our lives every day, and that happens to be breastfeeding.
As difficult and exhausting as breastfeeding a toddler can be at times, I truly can’t imagine ending our journey any time soon. Thankfully my husband is always there to help whenever I need a break or some personal space. Without all the extra help from our family, I’m not sure I’d be able to continue on this way. The days that my son is overly attached to me and practices his acrobatic moves are almost enough to make me want to quit, especially during the days leading up to my period as the nursing aversions kick in. But then I remind myself that he’s nursing for a reason, and regardless of what the reason is, breastfeeding makes him feel better which helps to keep me calm too. Maybe he has more teeth coming in, maybe he is angry because I wouldn’t give him another cookie, perhaps he fell and got a booboo, or maybe he is tired. Even though my baby isn’t really a baby anymore, breastfeeding still fulfills his emotional needs which consequently helps me to feel at ease. For this reason I’ve learned to go with the flow and stop counting how many times a day he wants to nurse because I will be here for as long as he needs me. I know I’ll be sobbing once these days are over and I’ll have to find new ways to comfort my child.
Other challenges of nursing toddlers and young children include their size. Eventually the child becomes too heavy to place down gently after nursing to sleep and mamma’s arms will fall asleep and go numb; for this reason it’s wise to nurse in bed before nap time or at night! When you are nursing a very awake toddler, they may tend to move a lot and switch sides often while nursing throughout the day which can be bothersome or result in sore nipples. This is when boundaries also come into play. Toddlers and older children can get distracted easily so don’t be surprised if they nurse for only seconds or a minute at a time. Finally, you’ll have to find new positions again to help with their latch. Toddlers may want to nurse standing up, while dancing, or sitting on your lap straddled.
Despite the many obstacles mothers encounter while breastfeeding beyond infancy, the benefits for mothers are greater with time. In fact, the longer a woman breastfeeds for, the more she decreases her risks for breast cancer. Breastfeeding is also known to reduce the risk of ovarian, uterine and endometrial cancers. Exclusive breastfeeding on demand delays the return of fertility in many women which is a natural contraceptive that allows nature to heal the mother's body until she is ready for another pregnancy. Other commonly known benefits for the breastfeeding mother include reduced risks of the following conditions: rheumatoid arthritis, cardiovascular disease, type 2 diabetes. Breastfeeding is also known to contribute to quicker weight loss postpartum¹.
“Longer breastfeeding duration is further associated with reduced maternal risks of breast cancer, ovarian cancer, diabetes, hypertension, obesity, and heart attack.” (ABM 2012)¹
By now you’re probably wondering: How long do children breastfeed for? The natural age of weaning when it is child-led is 2.5-7 years old³. Even though most people refer to breastfeeding beyond infancy as extended breastfeeding, this is considered breastfeeding natural term (when the child decides to stop nursing). The average age of weaning is said to be 2-4 years, however it seems that numerous factors can contribute to these averages. Many societies put pressure on mothers to wean well before age 2 and may pass judgement if they see a toddler nursing in public.
Another incredible fact about breast milk is that the antibodies and immune factors are highest when the amount is low. This occurs at birth when a breastfeeding journey begins and again during weaning when it comes to an end. This is nature’s way of giving a boost of protection to our children when they need it most, although these components are present in breast milk for the entire duration of breastfeeding.
"Antibodies are abundant in human milk throughout lactation” (Nutrition During Lactation 1991; p. 134). In fact, some of the immune factors in breastmilk increase in concentration during the second year and also during the weaning process. (Lawrence & Lawrence 2011, Goldman 1983, Goldman & Goldblum 1983, Institute of Medicine 1991)¹
Always remember that only the people involved in a breastfeeding relationship have any say on when the journey should come to an end. If you are able to and choose to breastfeed to natural term or until your child self-weans, that is great for so many reasons. If you decide to wean prior to that for whatever reason, that’s absolutely fine too. Each family must do what is best for their unique circumstances and everyone else’s opinions simply do not matter. It is always best for both mother and child to wean gradually and gently as opposed to abrupt weaning if possible. There are plenty of gentle weaning techniques available for those who have chosen planned weaning. Partial weaning may also be useful for mothers who are unsure about weaning but need to start setting respectful boundaries or limit nursing sessions with a toddler or young child.
Bonyata, K. (2018, January 13). Breastfeeding Past Infancy: Fact Sheet • KellyMom.com. Retrieved July 26, 2020, from https://kellymom.com/ages/older-infant/ebf-benefits/
Breastfeeding Beyond a Year. (2018, September 18). Retrieved July 26, 2020, from https://www.laleche.org.uk/breastfeeding-beyond-a-year/
Dettwyler, K., PhD. (1997, February 10). A Natural Age of Weaning [PDF]. College Station: Texas A and M University.
Importance of infant diet in establishing a healthy gut. (2018, October 24). Retrieved July 26, 2020, from https://www.sciencedaily.com/releases/2018/10/181024131243.htm
Nutrition for Breastfeeding Toddlers • KellyMom.com. (2018, January 15). Retrieved July 26, 2020, from https://kellymom.com/nutrition/starting-solids/toddler-foods/
Disclaimer: This information is not medical advice. It is shared by me, a lactation counselor, educator and mother, working to normalize breastfeeding and sharing valid information to help empower and support all families.